Provider Demographics
NPI:1548715592
Name:ERRICKSON, ASHLEY BARBARA (LAT ATC)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:BARBARA
Last Name:ERRICKSON
Suffix:
Gender:F
Credentials:LAT ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 E EVANS ST
Mailing Address - Street 2:C318
Mailing Address - City:WEST CHESTER
Mailing Address - State:PA
Mailing Address - Zip Code:19380-2739
Mailing Address - Country:US
Mailing Address - Phone:717-712-6683
Mailing Address - Fax:
Practice Address - Street 1:300 E EVANS ST
Practice Address - Street 2:C318
Practice Address - City:WEST CHESTER
Practice Address - State:PA
Practice Address - Zip Code:19380-2739
Practice Address - Country:US
Practice Address - Phone:717-712-6683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-19
Last Update Date:2016-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PART0058852255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer